=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861340978
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BASMA HADDAD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2026
-----------------------------------------------------
Last Update Date | 03/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1186 EAGLE NEST CT
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48381-2730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-320-3740
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1186 EAGLE NEST CT
-----------------------------------------------------
City | MILFORD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48381-2730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-320-3740
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHOLOGIST
-----------------------------------------------------
Name | MRS. BASMA HADDAD
-----------------------------------------------------
Credential | MA, LLP
-----------------------------------------------------
Telephone | 248-320-3740
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------